Immature defense mechanisms predict poor response to psychotherapy in major depressive patients with comorbid cluster B personality disorder

Objective: To evaluate the impact of defense mechanisms at baseline on depressive symptoms after brief psychotherapies and after 6-months of follow-up among depressed patients with and without cluster B personality disorders (PDs). Methods: This quasi-experimental study nested within a randomized clinical trial included a clinical sample of adults (18-60 years) diagnosed with major depressive disorder using the Mini-International Neuropsychiatric Interview. The Millon Clinical Multiaxial Inventory-III was applied to assess PD, the Defense Style Questionnaire 40 was used to analyze defense mechanisms, and the Beck Depression Inventory was used to measure the severity of depressive symptoms. Adjusted analysis was performed by linear regression. Results: The final sample consisted of 177 patients diagnosed with major depressive disorder, of whom 39.5% had cluster B PDs. Immature defenses at baseline significantly predicted the persistence of depressive symptoms at post-intervention and at 6-months of follow-up only in patients with PDs. Conclusion: In depressed patients with cluster B PDs, immature defenses predicted a poor response to brief therapies. The assessment of immature defenses at baseline can help identify patients at greater risk of poor therapeutic results and enable more appropriate treatment choices.

Huesos de la cabeza neumatizados. Enfoque unitario / Pneumatized Head Bones. Unitary Approach

Introducción: muchos huesos que forman el esqueleto de la cabeza humana y muchas especies de animales están neumatizados. Se han planteado múltiples hipótesis con diversos enfoques con la intención de explicar la existencia de estos espacios aéreos. De todos los huesos con estas características en humanos, solamente los senos paranasales y la neumatización del hueso temporal han sido objeto de múltiples hipótesis. La diversidad de criterios denota un desacuerdo, si no con todos, con la mayoría de ellos. Material y métodos: esta teoría se basa en reflexiones personales apoyadas en radiografías e imágenes anatómicas de los huesos frontal y temporal, con el objetivo de ilustrar y reforzar las razones de la existencia de estas cavidades en todas las especies que las poseen. Resultados, discusión y conclusiones: estos espacios de aire se forman en el cuerpo de los huesos cortos como un mecanismo de defensa natural al reemplazar el tejido esponjoso para prevenir infecciones graves del mismo (osteomielitis), que dada su proximidad al cerebro y sus estructuras representaría un peligro para la vida. Consideramos que los laberintos etmoidales fueron creados con el objetivo de llenar el espacio vacío entre los huesos vecinos y dar estabilidad al esqueleto óseo circundante. La neumatización del hueso temporal (hueso compacto) fue creada para "alojar y proteger" importantes estructuras de los sentidos del oído y del equilibrio, los vasos y los nervios.

Introduction: Many bones that make up the skeleton of the human head and many species of animals are pneumatized. Multiple hypotheses with various approaches have been stated with the intention of explaining the existence of these airspaces. Of all the bones with these characteristics in humans, only the paranasal sinuses and pneumatization of the temporal bone have been the subject of multiple hypotheses. The diversity of criteria denotes disagreement, if not with all, with the majority of them. Material and methods: This theory is based on personal reflections supported by x-rays and anatomical images of the frontal and temporal bones, with the aim of illustrating and reinforcing the reasons for the existence of these cavities in all species that possess them. Results, discussion and conclusions: These air spaces are formed in the body of short bones as a natural defense mechanism by replacing the spongy tissue to prevent serious infections of the same (osteomyelitis), which given its close proximity to the brain and its structures would represent a danger to life from its emergence. We consider that the ethmoid labyrinths were created with the aim of filling the empty space between the neighboring bones to give stability to the surrounding bone skeleton. The pneumatization of the temporal bone, compact bone, was created to "house and protect" important structures of the senses of hearing and balance, vessels and nerves

Suffering and defense mechanisms: an analysis of the work of Primary Health Care nurses / Sufrimiento y mecanismos de defensa: análisis del trabajo de enfermeras de la Atención Primaria de Salud / Sofrimento e mecanismos de defesa: análise do trabalho de enfermeiras na Atenção Primária à Saúde

ABSTRACT Objective: To analyze the suffering and coping strategies of nurses working in Primary Health Care considering the psychodynamics of their work. Methods: Descriptive study with a qualitative approach, carried out with 11 nurses working in Primary Health Care. Data were collected through semi-structured interviews, systematized, and interpreted using Bardin's content analysis method applied to recurrent themes. Results: The suffering factors related to work in Primary Health Care are difficulties with management, the fragile structure of the health support network, and conflicts with the users. Defensive strategies to minimize these difficulties are the support of hierarchical superiors, the empowerment of the community and users, and communication between team members. Final considerations: It is important that there be changes in the organization of this line of work to improve the workers' health.

RESUMEN Objetivo: Analizar el sufrimiento y mecanismos de defensa de enfermeros actuantes en la Atención Primaria de Salud a la luz de la psicodinámica del trabajo. Métodos: Estudio descriptivo con abordaje cualitativo realizado con 11 enfermeras actuantes en la Atención Primaria de Salud. Datos fueron recolectados mediante entrevista semiestructurada, sistematizados e interpretados utilizándose el análisis de contenido de Bardin en la modalidad temática. Resultados: Factores de sufrimiento relacionados al trabajo en la Atención Primaria de Salud son las dificultades con la gestión, estructura debilitada de la red de apoyo a la salud y conflictos con los usuarios. Las estrategias defensivas para minimizar esas dificultades son el apoyo de los superiores jerárquicos, el empoderamiento de la comunidad o de los usuarios y la comunicación entre los miembros de equipe. Consideraciones finales: Es importante que haya cambios en la organización del trabajo para que mejorías sean alcanzadas en la salud de los trabajadores.

RESUMO Objetivo: Analisar o sofrimento e os mecanismos de defesa de enfermeiros atuantes na Atenção Primária à Saúde à luz da psicodinâmica do trabalho. Métodos: Estudo descritivo com abordagem qualitativa realizado com 11 enfermeiras atuantes na Atenção Primária à Saúde. Os dados foram coletados mediante entrevista semiestruturada, sistematizados e interpretados utilizando-se a análise de conteúdo de Bardin na modalidade temática. Resultados: Os fatores de sofrimento relacionados ao trabalho na Atenção Primária à Saúde são as dificuldades com a gestão, a estrutura fragilizada da rede de apoio à saúde e os conflitos com os usuários. As estratégias defensivas para minimizar essas dificuldades são o apoio dos superiores hierárquicos, o empoderamento da comunidade ou dos usuários e a comunicação entre os membros de equipe. Considerações finais: É importante que haja mudanças na organização do trabalho para que melhorias sejam alcançadas na saúde dos trabalhadores.

The rise of psychoanalysis in US hospitals: William Alanson White at St. Elizabeths, 1903-1937 / El auge del psicoanálisis en los hospitales de EEUU: William Alanson White en St. Elizabeths, 1903-1937

Abstract William Alanson White's views on the function and conceptualization of psychoanalysis shaped the practice of the analytic method in the hospital setting in the United States. Here I explore White's original work and maintain that his understanding of transference, the unconscious, symbolism, language, and defense mechanisms were rooted in both traditional intrapsychic and individualistically oriented conceptions and influenced by his orientation toward social psychiatry. In line with Progressive Era ideals, White considered the new science of psychoanalysis important for healing both the individual as well as society; this mutual influence helped shape the evolution of psychoanalytic principles and informed the treatment of patients undergoing psychoanalysis at St. Elizabeths Hospital.

Resumen Las opiniones de William Alanson White sobre la función y la conceptualización del psicoanálisis dieron forma a la práctica del método analítico en el ámbito hospitalario de los EEUU. Aquí exploro el trabajo original de White y sostengo que su comprensión de la transferencia, el inconsciente, el simbolismo, el lenguaje y los mecanismos de defensa estaban enraizados tanto en las concepciones intrapsíquicas tradicionales como en las de orientación individualista e influenciadas por su orientación hacia la psiquiatría social. Conforme con los ideales de la Era Progresista, White consideró que la nueva ciencia del psicoanálisis era importante para curar tanto al individuo como a la sociedad; esta influencia mutua ayudó a dar forma a la evolución de los principios psicoanalíticos y mostró el tratamiento de los pacientes sometidos a psicoanálisis en el Hospital St. Elizabeths.

Relationship between childhood trauma, parental bonding, and defensive styles and psychiatric symptoms in adult life

Abstract Introduction A relationship between different types of childhood trauma, parental care, and defensive styles and development of psychiatric symptoms in adulthood is proposed in this study. Understanding the nature of this association is essential to assist psychotherapists who treat patients with a history of past trauma. This study aims to examine the associations between childhood trauma, parental bonding, and defensive styles and current symptoms in adult patients who sought care at an analytical psychotherapy clinic. Methods The sample comprised 197 patients from an analytically oriented psychotherapy clinic. Participants responded to four self-report instruments that assessed, respectively, presence and frequency of several types of early trauma, type of parental attachment, styles of defenses, and current symptoms encompassing a wide variety of psychopathological syndromes. Results Only 5% of patients reported not having experienced any traumatic experience in childhood. Several traumas such as emotional and physical abuse, emotional neglect, and physical neglect showed positive and significant associations with several dimensions of current symptoms, and also with parental bonding and defensive styles. When analyzed together with the other variables, defensive styles explained the level of psychological suffering caused by the symptoms. Conclusions This study offers additional support for understanding the associations between childhood trauma, parental bonding styles, and defense styles and the psychiatric symptoms of patients in analytically oriented psychotherapy.

The cacophony of emotions in a mental health professional from the isolation ward during coronavirus disease 2019 (COVID-19) pandemic

This commentary is on the narrative of the thoughts of a first-line healthcare worker, and the psychological overview of the same while working in isolation ward and being in quarantine during coronavirus disease 2019 (COVID-19) pandemic.

Estructuración de la personalidad en niños y niñas abandonados por sus progenitores / Personality structuring in children abandoned by their parents

Resumen Esta investigación expone cómo la ausencia de ambos padres afecta la estructuración de la personalidad en los niños y niñas que vivencian el abandono, tomando como aporte lo planteado por la teoría sistémica respecto a la familia, la cual la considera como el primer ente de contacto y el espacio en que se inicia el desarrollo psicológico y social de las personas; igualmente lo planteado por la teoría psicoanalítica en cuanto a la estructuración de la personalidad. La familia es considerada como una pieza fundamental en el desarrollo psicológico del niño; por lo tanto, la presencia de ambos padres cumple un papel significativo durante el crecimiento físico y psicológico. El objetivo principal fue analizar cómo se está estructurando la personalidad en los niños y niñas abandonados por sus progenitores. La investigación se ajusta al método cualitativo, y en ella participaron seis menores de uno y otro sexo, cuyas edades oscilaron entre los nueve y once años de edad; los participantes formaban parte del ICBF (Instituto Colombiano de Bienestar Familiar). Se aplicaron entrevistas abiertas en total dos pruebas proyectivas: el CAT (Test de Apercepción Temática para niños CATA) y Test del Dibujo de la Familia, estudio de caso, historia clínica y observaciones personalizadas. Se destaca que los niños y niñas actualmente no cuentan con la presencia de una figura masculina que pueda cumplir con las funciones de una figura paterna y que pueda dar paso a que el Edipo encuentre una salida adecuada; además las mujeres encargadas de los cuidados de los participantes cambian con frecuencia lo cual genera en ellos dificultades en el establecimiento de vínculos afectivos seguros, y presentan un yo y superyó débiles y con notables vacíos afectivos en sus relaciones vinculares primarias.

Abstract This exposes how the absence of both parents affects the structuring of the personality in the boys and girls who experience the abandonment, taking as contribution what was proposed by the systemic theory in front of the family, which considers it as the first entity of contact and the space in which the psychological and social development of people begins, likewise what is posed by psychoanalytic theory regarding the structuring of personality. The family is considered as a fundamental piece in the child's psychological development, therefore the presence of both parents plays a significant role during physical and psychological growth. The main objective was to analyze how the personality is being structured in children abandoned by their parents. The research is adjusted to the qualitative method, where six minors of both sexes participated, whose ages ranged from nine to eleven years of age; the participants were part of the ICBF (Colombian Institute of Family Welfare). Two projective tests were applied to open interviews: the CAT (Thematic Apperception Test for children CATA) and the Family Drawing Test, case study, medical history and personalized observations. It is highlighted that boys and girls currently do not they have the presence of a male figure who can fulfill the functions of a father figure and who can make way for the Oedipus to find a suitable outlet; furthermore, the women in charge of the care of the participants change frequently, generating difficulties in establishing secure affective bonds, presenting a weak self and superego and with notable affective gaps in their primary bonding relationships.

Vivências de prazer-sofrimento na organização do trabalho dos policiais militares da Região Norte / Experiences of pleasure-suffering in the work organization of military police officers in the Northern Region

Este estudo analisou as vivências de prazer-sofrimento dos policiais militares de um batalhão da região Norte e como estas influem na execução de suas atividades. Os pressupostos teórico-metodológicos procederam da Psicodinâmica do Trabalho. Foram realizados seis encontros em grupo com a participação de 17 policiais, sendo 14 homens e três mulheres. As temáticas investigadas foram divididas em cinco eixos: condições precárias de trabalho; perfil do policial; reconhecimento dos pares, superiores e sociedade; prazer-sofrimento no trabalho; e defesas contra o sofrimento, interpretados a partir da análise temática. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade. Percebeu-se que a organização de trabalho desempenha papel importante nas vivências de prazer-sofrimento e que cooperação, reconhecimento, precarização, burocracia e os paradoxos da atividade policial interferem diretamente nesta dinâmica. O uso de estratégias defensivas, como a ironia e o humor, é responsável pela dicotomia entre ter que suportar o real no trabalho e não verbalizar o sofrimento, evidenciando alguns dos importantes paradigmas presentes na atividade militar estudada.

This study analyzed the experiences of pleasure-suffering of a Military Police Battalion from the Northern Region and how they influence the execution of their activities. The theoretical-methodological assumptions adopted were the Psychodynamics of Work. Six group meetings were held with the participation of seventeen policemen: fourteen men and three women. The investigated thematics were divided into five axes, namely: precarious working conditions; profiles of the police officers; acknowledgment among peers, superiors and society; pleasure-suffering at work; and defenses against suffering, according to thematic analysis. This project was approved by the university's Research Ethics Committee. The work organization played an important role in the pleasure-suffering experiences, and cooperation, recognition, precariousness, bureaucracy and paradoxes of the police activity directly interfere in this dynamic. The use of defensive mechanisms such as irony and humor is responsible for the dichotomy between having to endure reality at work and as a means to not verbalize suffering, showing some of the important paradigms present in the military activity studied.

Para uma nova etiologia das neuroses: notas a partir da teoria das relações objetais de Donald W. Winnicott / For a new etiology of the neuroses: notes from Donald W. Winnicott's object relations theory / Para una nueva etiología de las neurosis: notas a partir de la teoría de las relaciones objetivas de Donald W. Winnicott

O presente trabalho objetiva analisar a etiologia das neuroses em Freud e Winnicott. Para tanto, parte das principais considerações sobre os mecanismos de defesa, o recalque, a sexualidade, o complexo edípico e o conflito psíquico na psicanálise clássica freudiana, para depois propor uma nova etiologia a partir da teoria das relações objetais em Donald W. Winnicott. Os autores não consideram apenas o conflito vivido em termos da dinâmica psíquica, mas aquele vivido na dinâmica mãe-bebê, principalmente a partir dos polos opostos entre o amor e o ódio na travessia do concernimento (posição depressiva). Os autores defendem um manejo clínico de pacientes com sofrimento psíquico neurótico a partir da psicanálise transmatricial, propondo, concomitantemente à associação livre, o uso da regressão à dependência a fases primitivas de falhas ambientais (AU)

This paper aims to analyze the etiology of the neuroses in Freud and Winnicott. In order to do so, the authors build upon the main considerations on defense mechanisms, repression, sexuality, the oedipal complex, and the psychic conflict in Freudian psychoanalysis. Then they propose a new etiology based on Donald W. Winnicott's object relations theory. The authors do not only consider the conflict experienced in terms of psychic dynamics, but also the conflict experienced in the mother-baby dynamics, particularly in regards to the opposition between love and hate in the development of concern (depressive position). The authors stand for the clinical management of patients with neurotic psychic suffering based on transmatricial psychoanalysis, proposing, along with free association, the use of regression to dependence on primitive phases of environmental failures (AU)

El presente trabajo tiene por objeto analizar la etiología de las neurosis en Freud y Winnicott. Para ello, parte de las principales consideraciones sobre los mecanismos de defensa, la represión, la sexualidad, el complejo edípico y el conflicto psíquico en el psicoanálisis freudiano, para proponer una nueva etiología a partir de la teoría de las relaciones objetivas en Donald W. Winnicott. Los autores no sólo consideran el conflicto vivido en términos de la dinámica psíquica, sino el conflicto vivido en la dinámica madre-bebé, principalmente a partir de los polos opuestos entre el amor y el odio en la travesía de la concernimiento (posición depresiva). Los autores defienden un manejo clínico de pacientes con sufrimiento psíquico neurótico a partir del psicoanálisis transmatricial, proponiendo junto a la asociación libre, el uso de la regresión a la dependencia a fases primitivas de fallas ambientales (AU)

Defense mechanisms and quality of life of medical students according to graduation phase

Abstract Objectives To compare health-related quality of life (QoL) of medical students in initial and final phases of the program, and to evaluate the association between ego defense mechanisms and specific health-related QoL domains within each group. Methods This was an observational, cross-sectional study. Quality of life was assessed according to the World Health Organization Quality of Life instrument - Abbreviated Version (WHOQOL-Bref); anxiety and depression symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS); defense mechanisms were assessed using the Defense Style Questionnaire (DSQ-40) Results A total of 139 medical students were evaluated. Students in the initial semesters of the program (1st and 3rd) presented more depressive symptoms and worse quality of life in the psychological domain of WHOQOL-Bref when compared to those in the final semesters (8th and 12th). In a later analysis, conducted to identify the variables associated with the psychological domain of the WHOQOL-Bref for each group, both depressive symptoms and defense mechanisms were independently associated with the outcome for medical students in the beginning and in the end of the graduation program. Conclusions Students in the initial phases of medical school may need more specific attention from educational managers. Understanding the role of ego defense mechanisms in the quality of life of medical students may help identify effective psychopedagogical interventions for this population. In addition, the results reinforce the impact of depressive symptoms on quality of life, an association already well evidenced in the literature.

Estratégias coletivas de defesa da equipe de enfermagem no contexto do cuidado oncopaliativo / Collective defense strategies of the nursing team in the context of oncopalliative care

O objeto deste estudo tratou das estratégias coletivas de defesa adotadas pela equipe de enfermagem no processo de cuidar-cuidado a pacientes com doença oncológica em tratamento paliativo. Objetivos: a) identificar a configuração da organização do trabalho para o desenvolvimento da assistência ao paciente com doença oncológica em cuidados paliativos; b) analisar os sentimentos que emergem da equipe de enfermagem sobre o processo de trabalho direcionado ao paciente com doença oncológica em cuidados paliativos; e c) discutir as estratégias coletivas de defesa adotadas pelos trabalhadores de enfermagem diante do paciente com doença oncológica em cuidados paliativos. O estudo foi aprovado pelo Comitê de Ética em Pesquisa (CEP) sob número de protocolo: 2.601.416 e Certificado de Apresentação para Apreciação Ética (CAAE): 81886917.7.0000.5282. Metodologia: Estudo qualitativo e descritivo cujos participantes foram 18profissionais de enfermagem: três enfermeiros, onze técnicos de enfermagem e quatro enfermeiros residentes de um hospital universitário do estado do Rio de Janeiro. A coleta de dados ocorreu em julho de 2018 por meio da técnica de grupo focal e observação participante. O tratamento dos dados ocorreu por meio da técnica de Análise Temática de Conteúdo. Resultados: O procedimento de análise adotado fez emergir três categorias as quais estão descritas a seguir. 1) Configurações da organização do trabalho e a problemática da assistência ao paciente com doença oncopaliativa, em que se discutiram os aspectos estruturais, condições de conforto ao paciente, processos de comunicação em equipe, a problemática da formação profissional e seus reflexos na assistência ao paciente com doença oncopaliativa. 2) Sentimentos decorrentes do processo de cuidar-cuidado ao paciente com doença oncopaliativa, em que se analisaram os sentimentos que emergem durante a assistência ao paciente com doença oncopaliativa; e as percepções resultantes da vivência e do acompanhamento do processo de morte e morrer. 3) Estratégias defensivas adotadas para o cuidado dos pacientes com doença oncopaliativa, cuja categoria discutiu as estratégias coletivas e individuais de defesa para o enfrentamento de situações relativas ao cuidado dos pacientes com doença oncopaliativa. Conclusão: Os resultados evidenciaram que os cenários investigados possuem estrutura física inadequada para a prestação de cuidados paliativos, além de um processo de comunicação pouco eficaz entre os membros da equipe multidisciplinar bem como a qualificação profissional deficitária para o processo de cuidado a pacientes com doença oncopaliativa. Os profissionais vivenciam sentimento de tristeza, angústia, dor, medo e impotência quando não conseguem manter a vida do paciente, demonstrando pouca compreensão sobre o processo de morte/ morrer. Tal contexto favorece a emersão de estratégias coletivas e individuais de defesa a fim de neutralizar e/ou minimizar o sofrimento. Conhecer tais estratégias contribui para elaborar ações e medidas para salvaguardar a saúde destes trabalhadores.

The object of this study dealt with the collective defense strategies adopted by the nursing team in the process of care/caring for patients with oncological disease under palliative treatment. Objectives: a) to identify the configuration of the work organization for the care of patients with oncological disease under palliative care; b) to analyze the feelings that emerge from the nursing team about the process of work directed to the patient with oncological disease under palliative care; and; c) to discuss the collective defense strategies adopted by the nursing professionals when in front of an oncological patient under palliative care. The study was approved by the Research Ethics Committee under protocol number 2,601,416 and Certificate of Presentation for Ethical Appreciation: 81886917.7.0000.5282. Methodology: Qualitative descriptive study whose participants were 18 nursing professionals 18: three nurses, 11 nursing technicians and four resident nurses of a university hospital in the State of Rio de Janeiro. The data were collected in July 2018 through focal group and participant observation. The data treatment occurred by means of the thematic content analysis technique. Results: The adopted analysis procedure brought out three categories as described hereinafter: 1) Work organization configurations and the problem of assistance to the patient with oncopalliative disease, which discussed the structural aspects, patient's comfort conditions, team communication processes, the problem of professional training and its reflexes in the assistance to oncopalliative patients. 2) Feelings arising from the process of care/caring for the patient with oncopalliative disease, which analyzed the feelings that emerge during assistance to the patient with oncopalliative disease; and the perceptions from experiencing and accompanying the process of death and dying. 3) Defensive strategies adopted for the care of patients with oncopalliative disease, which discussed the collective and individual defense strategies used to cope with situations related to the care of patients with oncopalliative disease. Conclusion: The results showed that the investigated scenarios have inadequate physical structure for the provision of palliative care, an ineffective communication process among the multidisciplinary team members, as well as deficient training regarding the care of patients with oncopalliative disease. The professionals experience feelings of sadness, anguish, pain, fear and impotence when they fail to maintain the patient's life, showing little comprehension about the process of death/dying. Such context favors the emergence of collective and individual defense strategies in order to neutralize and/or minimize the suffering. Knowing these strategies contribute to the development of actions and measures to safeguard the health of these workers.

Direct Antiviral Mechanisms of Interferon-Gamma

Interferon-gamma (IFNG) is a pleiotropic cytokine that modulates both innate and adaptive immune networks; it is the most potent activator of macrophages and a signature cytokine of activated T lymphocytes. Though IFNG is now appreciated to have a multitude of roles in immune modulation and broad-spectrum pathogen defense, it was originally discovered, and named, as a secretory factor that interferes with viral replication. In contrast to the prototypical type I interferons produced by any cells upon viral infection, only specific subsets of immune cells can produce IFNG upon infection or stimulation with antigen or mitogen. Still, virtually all cells can respond to both types of interferons. This makes IFNG a versatile anti-microbial cytokine and also gives it a unique position in the antiviral defense system. The goal of this review is to highlight the direct antiviral mechanisms of IFNG, thereby clarifying its antiviral function in the effective control of viral infections.

Acute stress disorder and defense mechanisms: a study of physical trauma patients admitted to an emergency hospital / Transtorno de estresse agudo e mecanismos de defesa: pesquisa com pacientes que sofreram trauma físico atendidos em um hospital de emergência

Abstract Introduction: Acute stress disorder (ASD) encompasses a set of symptoms that can arise in individuals after exposure to a traumatic event. This study assessed the defense mechanisms used by victims of physical trauma who developed ASD. Method: This was a controlled cross-sectional study of 146 patients who suffered physical trauma and required hospitalization. A structured questionnaire was used to evaluate ASD symptoms based on DSM-5 diagnostic criteria, in addition to the Defense Style Questionnaire (DSQ). Results: Ten participants (6.85%) received a positive diagnosis of ASD, and 136, (93.15%) a negative diagnosis. The majority of the sample consisted of men with median age ranging from 33.50 to 35.50. The most prevalent defense mechanisms among the 10 patients with ASD were cancellation and devaluation, which belong to the neurotic and immature factors, respectively. Positive associations between the presence of symptoms from criterion B of the DSM-5 and defense mechanisms from the DSQ were found. These included the mechanisms of undoing, projection, passive aggression, acting out, autistic fantasy, displacement, and somatization. Conclusion: Patients with ASD employed different defense mechanisms such as undoing and devaluation when compared to patients not diagnosed with ASD. These results mark the importance of early detection of ASD symptoms at a preventative level, thereby creating new possibilities for avoiding exacerbations related to the trauma, which represents an important advance in terms of public health.

Resumo Introdução: O transtorno de estresse agudo (TEA) reúne um conjunto de sintomas que pode surgir nos indivíduos após exposição a um evento traumático. Este estudo verificou a relação entre o estilo defensivo e o desenvolvimento de TEA e seus sintomas em uma amostra de pacientes que sofreram trauma físico. Métodos: Este estudo transversal controlado envolveu 146 pacientes que sofreram trauma físico e necessitaram hospitalização. Um questionário estruturado foi utilizado para avaliar sintomas de TEA, baseado nos critérios diagnósticos do DSM-5, além do Questionário de Estilo Defensivo (Defense Style Questionnaire - DSQ). Resultados: Dez (6,85%) pacientes tiveram diagnóstico positivo para TEA, e 136 (93,15%), diagnóstico negativo. A maioria da amostra foi composta por homens com idade mediana variando de 33,50 a 35,50. Nos 10 pacientes positivos para TEA, destacou-se a maior utilização de mecanismos de defesa de anulação e desvalorização, pertencentes ao fator neurótico e ao fator imaturo, respectivamente. Foram observadas associações positivas entre presença de sintomas de TEA do critério B do DSM-5 e os mecanismos de defesa do DSQ, sobretudo nos mecanismos de anulação, projeção, agressão passiva, acting out, fantasia autística, deslocamento e somatização. Conclusão: Pacientes com TEA utilizaram mais mecanismos de defesa do tipo anulação e desvalorização quando comparados aos pacientes sem diagnóstico de TEA. Ressalta-se a importância da detecção precoce de sintomas de TEA a fim de evitar outros agravos relacionados ao trauma, o que representa uma importante evolução em termos de saúde pública.

Plant antiherbivore defenses in Fabaceae species of the Chaco / Defesas das plantas anti-herbivoria em espécies de Fabaceae do Chaco

Abstract The establishment and maintenance of plant species in the Chaco, one of the widest continuous areas of forests in the South American with sharp climatic variations, are possibly related to biological features favoring plants with particular defenses. This study assesses the physical and chemical defenses mechanisms against herbivores of vegetative and reproductive organs. Its analyses of 12 species of Fabaceae (Leguminosae) collected in remnants of Brazilian Chaco shows that 75% present structural defense characters and 50% have chemical defense - defense proteins in their seeds, like protease inhibitors and lectins. Physical defenses occur mainly on branches (78% of the species), leaves (67%), and reproductive organs (56%). The most common physical characters are trichomes and thorns, whose color represents a cryptic character since it does not contrast with the other plant structures. Defense proteins occur in different concentrations and molecular weight classes in the seeds of most species. Protease inhibitors are reported for the first time in seeds of: Albizia niopoides, Anadenanthera colubrina, Mimosa glutinosa, Prosopis rubriflora, and Poincianella pluviosa. The occurrence of physical and chemical defenses in members of Fabaceae indicate no associations between defense characters in these plant species of the Chaco.

Resumo O estabelecimento e a manutenção de espécies no Chaco, uma planície semi-árida da América do Sul com variações climáticas importantes, possivelmente estão relacionados a características biológicas que favorecem as plantas detentoras de defesas particulares. Este estudo teve como objetivos avaliar os mecanismos de defesa física e química anti-herbivoria em órgãos vegetativos e reprodutivos. Analisamos 12 espécies da família Fabaceae (Leguminosae) obtidas em remanescentes de Chaco brasileiro. Observamos que 75% das espécies estudadas apresentam atributo de defesa física e 50% possuem defesa química - proteínas de defesa nas sementes, como inibidores de protease e lectinas. As defesas físicas ocorrem principalmente nos ramos (78% das espécies), nos órgãos reprodutivos (56% das espécies) e nas folhas (67%). Os atributos físicos mais frequentes são tricomas e espinhos, cuja coloração não contrastante com as demais estruturas das plantas representa um caráter críptico. Proteínas de defesa ocorrem nas sementes da maioria das espécies, com diferentes concentrações e classes de pesos moleculares. Inibidores de protease nas sementes estão sendo relatados pela primeira vez em: Albizia niopoides, Anadenanthera colubrina, Mimosa glutinosa, Prosopis rubriflora e Poincianella pluviosa. A ocorrência de defesas física e química entre os membros de Fabaceae indica que não há associações entre as características de defesa das espécies de plantas avaliadas no Chaco.

Association between resilience and posttraumatic stress disorder among Brazilian victims of urban violence: a cross-sectional case-control study / Associação entre resiliência e transtorno de estresse pós-traumático em vítimas de violência urbana no Brasil: estudo transversal de caso e controle

Abstract Introduction This study investigated the association between resilience and posttraumatic stress disorder (PTSD) among Brazilian victims of urban violence. It also compared defense mechanisms, parental bonding, and childhood trauma between those who developed PTSD and those who did not. Methods This cross-sectional case-control study included 66 adult subjects exposed to recent urban violence in southern Brazil - 33 with PTSD and 33 healthy controls matched by sex and age - who were administered the Resilience Scale, Defense Style Questionnaire, Parental Bonding Instrument, and Childhood Trauma Questionnaire. The statistical tests used were the McNemar test for categorical variables, the Wilcoxon signed-rank test for continuous asymmetric variables, and the paired Student t-test for continuous symmetric variables. Results The PTSD group showed lower total Resilience Scale scores compared with controls (128.4±20.7 vs. 145.8±13.1, respectively; p = 0.01), along with a lower ability to solve situations and lower personal values that give meaning to life (p = 0.019). They also had lower rates of mature defense mechanisms (p < 0.001) and higher rates of emotional (p = 0.001) and physical (p = 0.003) abuse during childhood. Conclusion Lower levels of resilience, especially the ability to solve situations and having personal values that give meaning to life, immature defense mechanisms, and emotional and physical abuse in childhood are associated with PTSD in adult Brazilian victims of urban violence.

Resumo Introdução Este estudo investigou a associação entre resiliência e transtorno de estresse pós-traumático (TEPT) entre vítimas brasileiras de violência urbana. Comparou os mecanismos de defesa, vínculos parentais e trauma infantil entre vítimas que desenvolveram TEPT e vítimas que não desenvolveram o transtorno. Métodos Estudo de caso-controle transversal que incluiu 66 sujeitos adultos expostos à violência urbana no sul do Brasil. Foram avaliados 33 pacientes com TEPT e 33 controles saudáveis pareados por sexo e idade, que responderam a Escala de Resiliência, Questionário do Estilo Defensivo, Instrumento de Ligação Parental e Questionário sobre Traumas Infantis. Os testes estatísticos utilizados foram o teste de McNemar para variáveis categóricas, teste Wilcoxon para variáveis assimétricas contínuas e teste tde Student pareado para variáveis simétricas contínuas. Resultados O grupo que desenvolveu TEPT apresentou escores totais da Escala de Resiliência mais baixos em relação aos controles (128,4±20,7 versus145,8±13,1, respectivamente; p = 0,01), juntamente com uma menor capacidade em resolver situações e menores índices de valores pessoais que dão sentido à vida (p = 0,019). Também apresentaram taxas mais baixas de uso de mecanismos de defesas maduros (p < 0,001) e maiores taxas de abuso emocional (p = 0,001) e físico (p = 0,003) durante a infância. Conclusão Níveis mais baixos de resiliência, especialmente a capacidade de resolver situações e ter valores pessoais que dão sentido à vida, mecanismos imaturos de defesa e abuso físico e emocional na infância estão associados ao TEPT em adultos vítimas de violência urbana no Brasil.

As contingências do trabalho bancário: um estudo sobre os mecanismos de mediação e defesa do sofrimento / Social skills training: evaluation of an interpersonal professional development program for undergraduates of exact sciences courses

O setor bancário sofre mudanças importantes desde a reestruturação produtiva na década de 90, implicando redução significativa no contingente de trabalhadores e transformações na organização do trabalho. Estas contingências impactam na saúde mental do bancário, sendo re­ levante investigar os mecanismos de mediação e defesa do sofrimento utilizados pelos trabalhadores diante deste contexto. Esta pesquisa descritiva, de abordagem qualitativa, foi realizada por meio de entrevistas com bancários de instituição privada de atuação nacional, submetidas à análise de conteúdo. A investigação identificou os efeitos da organização do trabalho, onde as premissas da gestão geram importante individualização do trabalho, pois o bancário é tensionado pela pressão da meta e pela necessidade de reconhecimento. Há mobilização subjetiva no sentido de tentar mediar o sofrimento decorrente da dinâmica do trabalho, como evidenciado na superficialidade afetiva e no isolamento que busca dar conta da demanda de atribuições imposta, o que se reflete na condição de atendimento aos clientes.Dentre as estratégias de mediação presentes nas experiências dos participantes estão a cooperação, a inteligência prática e a transgressão; como mecanismos de defesa, foram identificados o cinismo viril, a insensibilidade afetiva, o isolamento e o adoecimento psíquico

The banking sector has undergone remarkable changes since the production restructuring in the 1990s, which caused a significant decrease in the number of workers and changes in the work organization. Such contingencies have caused an impact on the mental health of bank workers, and it is important to investigate the mechanisms of mediation and defense against suffering used by workers in this context. In this descriptive, qualitative research, bank workers of a national private institution were interviewed. The interviews were subjected to content analysis. The research identified the effects of work organization, where the management as­ sumption generates an important individualization of the work, since the banking workers are stressed by the pressure of the goal and the need for recognition. There is a subjective mobili­ zation trying to mediate the suffering resulting from the work dynamics, as evidenced by an af­ fective superficiality and the isolation that seeks to account for the demand for attributions imposed, which is reflected in the condition of customer service. The mediation strategies in the participants' experiences are cooperation, practical intelligence and transgression. Virile cynicism, affective insensitivity, isolation, and psychical illness were identified as defense me­ chanisms

Lisbeth Salander, más allá de la clasificación de rara o extraña: un estudio de caso sobre el personaje principal de la película Millenium / Lisbeth Salander, beyond the classification of rare or strange: a case study of the main character in the film Millenium

La presente investigación tiene como objetivo la realización de un perfil psicológico de un personaje de la tetralogía Millenium, más específicamente de Lisbeth Salander, su protagonista. Este perfil se basa en la revisión del material cinematográfico de la tetralogía y en la perspectiva psicodinámica. Dentro de los principales resultados encontrados, está el hecho que Lisbeth Salander tiene una estructura de personalidad esquizoide y no psicopática, como plantean otros; además de algunas debilidades de las funciones yoicas que posee el personaje.

This study aims to develop a psychological profile of one of the characters in the Millenium tetralogy, more specifically Lisbeth Salander. This profile is based on the review of the films of the tetralogy and some aspects from the psychodynamic perspective. Among the main findings is the fact that Salander has a schizoid personality structure and not a psychopathic one, as others claim, as well as the weaknesses of the ego functions that this character owns.

Risco invisível: trabalho e subjetividade no setor elétrico / Riesgo invisible: trabajo y subjetividad en el sector eléctrico / Invisible risk: work and subjectivity in the electricity sector

Resumo Este estudo se origina de uma pesquisa que abordou a noção de risco no trabalho no setor elétrico. O termo “risco invisível” surgiu do discurso dos trabalhadores do setor, referindo-se à eletricidade que não pode ser vista, mas oferece riscos específicos. Dá-se ênfase a uma análise da noção de risco, enquanto fenômeno da modernidade, mas passando também pela discussão da confiança básica e da segurança ontológica. Ao relacionar esse marco teórico com a realidade do trabalho no setor elétrico, entra em cena o articulador teórico dos mecanismos de defesa, através da psicodinâmica do trabalho. Do ponto de vista político, é importante refletir sobre a realidade da segurança no âmbito das relações de trabalho, já que os trabalhadores são expostos a riscos específicos em cada atividade. A reflexão teórica e observação empírica constante são um caminho para pensar intervenções no âmbito da dimensão sociopsicológica do risco no trabalho.

Resumen Este estudio se deriva de la investigación que se dirigió a la noción de riesgo en el trabajo en el sector eléctrico. El término "riesgo invisible" surgió de la voz de los trabajadores del sector, haciendo referencia a la electricidad, que no puede ser vista, pero, plantea riesgos específicos. Se hace necesario el análisis del concepto de riesgo como un fenómeno de la modernidad, pero también a través de la discusión de la confianza básica y la seguridad ontológica. Para relacionar este marco teórico con la realidad del trabajo en el sector eléctrico, entra en escena la articulación teórica de los mecanismos de defensa a través de la psicodinámica del trabajo. Desde el punto de vista político, es importante reflexionar a respecto de la realidad de la seguridad en el contexto de las relaciones laborales , ya que los trabajadores están expuestos a riesgos específicos de cada actividad. La reflexión teórica y la observación empírica consistente es una manera de pensar acerca de las intervenciones para la dimensión socio - psicológico de riesgo en el trabajo.

Abstract This study is part of a research work that approach aspects related to the work risk in the electricity sector. The term "invisible risk" came from the speech of the workers, referring to electricity, which can not be seen, but offers specific risks. We emphasize an analysis of the concept of risk as a phenomenon of modernity, but also through the discussion of basic trust and ontological security. By relating this theoretical framework with the reality of working in the electricity sector, enters the scene the theoretical articulation of defense mechanisms, through psychodynamics of work. From a political standpoint, it is important to reflect on the reality of security in the context of labor relations, as workers are exposed to specific risks in each activity. The theoretical reflection and empirical constant observation are one way to think about interventions within the socio-psychological dimension of risk at work.

O professor do fim do Ensino Fundamental I perante alunos com dificuldades de aprendizagem: questões psí­quicas e mecanismos de defesa / The teacher at the end of elementary school towards students with learning difficulties: psychic questions and defense mechanisms / El maestro del quinto ciclo de la educación básica ante alumnos con dificultades de aprendizaje: cuestiones psí­quicas y mecanismos de defensa

Este artigo visa apresentar tensões e questões psíquicas ligadas à confrontação do professor do fim do Ensino Fundamental I com alunos com dificuldade de aprendizagem e com "necessidades educativas especiais", de acordo com as normas institucionais. Esse profissional realiza seu trabalho no colégio em um entre-deux. Foi escolhido um método de pesquisa clínico de orientação psicanalítica. Ele permite apreender os movimentos psíquicos conscientes e inconscientes mobilizados na "personalidade profissional" e a relação específica estabelecida entre o professor de 5º ano e tais alunos ditos com necessidades especiais. A análise de entrevistas clínicas de pesquisa conduzidas com professores na França e em países francófonos valoriza modos de defesa específicos.

This article aims to present tensions and psychic issues related to the confrontation of the teacher at the end of Elementary School with students with learning difficulties and "special educational needs", according to institutional norms. These professionals carry out their work in an entre-deux. A method of clinical research with a psychoanalytic orientation was chosen. It allows us to grasp the conscious and unconscious psychic movements mobilized in the "professional personality" and the specific relationship established between the 5th grade teacher and those students with special needs. The analysis of clinical research interviews conducted with teachers in France and in French-speaking countries values specific defense methods.

En este texto se pretende presentar las tensiones y cuestiones psíquicas en la relación del maestro del 5º ciclo de la educación básica y los alumnos con dificultades de aprendizaje y con "necesidades educativas especiales" según las normas institucionales. Este profesional trabaja en el colegio en un entre-deux. Se empleó el método de investigación psicoanalítico, el que permitió conocer los movimientos psíquicos conscientes e inconscientes que moviliza la "personalidad profesional" y la relación establecida entre el maestro del 5º ciclo y los alumnos con necesidades especiales. Desde el análisis, las entrevistas clínicas con los maestros en Francia y en países de habla francesa muestran modos de defensa específicos.

Toxicity effect of cadmium stress exposure to insects and defense mechanism of insects / 中国药理学与毒理学杂志

Cadmium is one of the important heavy metal pollutants with strong toxicity and wide distribution. It poses a threat to human health and invertebrates,especially to insects. It has been demonstrated that cadmium can infiltrate into insects through respiration ,food intake and so on. It can affect their development,and even induce apoptosis via oxidative damage. Insects can gradually develop defense mechanisms against cadmium with the help of metallothionein,antioxidant enzymes, excretion and heat shock protein. Toxicity effect varies among different species. This paper reviewsed the effect of cadmium on development,cell apoptosis mechanism and defense mechanism in insects.